<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">

<html>
    <head>
        <title>Customer Registration Form </title>
    </head>
    <body>
        <form action="CustomerRegistration" method="post">
            <table width="100%" border="0" align="center">
                <tr align="center" valign="top">
                    <td colspan="2">
                        <h1><em><strong>Customer Registration Form</strong></em></h1>
                    </td>
                </tr>
                <tr>
                    <td>
                        <span><strong>User Id: </strong></span>
                    </td>
                    <td><input name="txtuserid" type="text" id="txtuserid" size="45" maxlength="35">
                    </td>
                </tr>
                <tr>
                    <td>
                        <span><strong>Password:</strong></span>
                    </td>
                    <td>
                        <input name="txtpassword" type="password"
                        id="txtpassword" size="12" maxlength="10">
                    </td>
                </tr>
                <tr>
                    <td>
                        <span><strong>Name:</strong></span>
                    </td>
                    <td>
                        <input name="txtname" type="text" id="txtname"
                        maxlength="15">
                    </td>
                </tr>
                <tr>
                    <td>
                        <span><strong>Gender:</strong></span>
                    </td>
                    <td>
                        <input name="rbgender" type="radio"
                        value="Male" checked> Male
                        <input name="rbgender" type="radio"
                        value="Female"> Female
                    </td>
                </tr>
                <tr>
                    <td>
                        <span><strong>Age:</strong></span>
                    </td>
                    <td>
                        <input name="txtage" type="text" id="txtage"
                        size="3" maxlength="2">Yrs.
                    </td>
                </tr>
                <tr>
                    <td>&nbsp;</td>
                    <td>
                        <input name="Submit" type="submit" value="Submit">
                        <input type="reset" name="Reset" value="Reset">
                    </td>
                </tr>
            </table>
        </form>
    </body>
</html>
